Bogus Children’s Remedy Invented by CBC Marketplace Approved by Health Canada

Nothing is better than Nighton

Like many Canadians who saw last week’s news article “Health Canada licensing of natural remedies ‘a joke,’ doctor says” in the lead-up to Friday’s Marketplace episode on CBC, I was very interested in learning the story behind it. Unlike many Canadians, I wasn’t at all shocked or surprised by the outcome. This blog (and others) have been critical for years about the lack of oversight where the Natural Health Products Directorate (NHPD) is concerned. (The NHPD recently changed its name to the Natural and Non-prescription Health Products Directorate. (NNHPD))  See “Do the Natural Health Products Regulations Benefit Canadians?”, “Health Canada Gets Out a Big Rubber Stamp”   & “Safe and Effective? A Consumer’s Guide to Natural Health Products” for some background. For those who haven’t had a chance to view the episode, it can be viewed here:

What’s wrong with supermarket pharmacies?

TEXT:

Former Fresh trader Steve Milton handles Healthcare sales as he would a bag of apples.

“I look at the job as similar to selling store products off the shelves,” said CTM Steve, whose influence at Greenhithe led to an 18% increase in Pharmacy sales after just three weeks.

Providing healthcare isn’t the same as selling apples, Steve.

H/T Sparkle Wildfire

 

THIEVES Essential Oil – Crimes against public health

As discussed in one of my previous posts, the promotion of quackery is so ubiquitous in my town it’s become white noise for me. I mostly tune it out unless I’m personally asked my opinion. Often this promotion comes in the weekly newspaper, in the advertising-disguised-as-advice page “Ask the Expert.” Occasionally there are columns by financial advisors and home improvement experts, but by far the majority of “expert advice” comes from chiropractors, naturopaths, Chinese Medicine practitioners, and holistic nutritionists. One regular advertiser is a local who calls herself a “Divine Healer”. She has some initials after her name, none of which I can trace back to any actual licenced health profession, degree or diploma. Her services include reflexology, mediumship, craniosacral therapy, aromatherapy and card-reading. She also offers a special massage called “vibrational raindrop technique” which apparently involves the use of essential oils and tuning forks or singing bowls. This actually sounds like it might be kind of relaxing and entertaining. Something I would personally never pay the money for, but harmless, right? Earlier this year, however, a local public health nurse who I consider a kindred spirit based on our views of alternative medicine contacted me about the weekly claim.

Does this make the homeopathy even more powerful?

Amazingly, the store retains the memory of being a homeopathy shop and continues to heal. (h/t @bexielady)

It Takes a Village – Skepticism in this Small Town

In my last post, I introduced myself as a pharmacist in a small-ish town, eager to combat the growing acceptance of pseudoscience into the mainstream.  I love living where I live for a multitude of reasons.  But I’ve found it rather challenging to wave the flag of skepticism.  I have no problem displaying my preference for science-based medicine at my workplace, but outside of work a rather large road-block has emerged – social isolation.  While I have found a few kindred spirits in a public health nurse and a high school science teacher, they, too, remain relatively quiet about their skepticism.  I decided a few months ago to push the boundaries, and learned the hard way why others have been forced to keep quiet.

The Evolution of a Skeptic Pharmacist

Today’s post is a guest contribution from a Canadian pharmacist who is writing under the pseudonym Sara Russell:

For several years after graduating from pharmacy school, when I’d answer the question “What do you do for a living?”, it would be met with responses like “Good for you!”, “You must be so smart!” or simply “Wow!”.  After a decade-long absence from a role in direct patient-care, I returned to pharmacy.  I noticed that my response to that same question was met with much less enthusiasm, with some people even having trouble hiding their disappointment.  How did this happen?  When did being a pharmacist have less caché than saying you worked in a health-food store?

Alternative….Literature?

Check out today’s xkcd. Follow the image link to the main site, and move your cursor over the comic to see Randall’s commentary on pharmacies selling homeopathy.

Today’s Reading List

As a change from some of the usual content I wanted to pass on some general articles on health, medicine and pharmacy practice I enjoyed recently.

Pharmacists: Ever dispensed a placebo?

From today’s National Post:

The practice is discouraged by major medical groups, considered unethical by many doctors and with uncertain benefit, but one in five Canadian physicians prescribes or hands out some kind of placebo to their often-unknowing patients, a new study suggests.

The article references a paper in the Canadian Journal of Psychiatry which does not appear to be online.

It continues:

McGill’s Prof. Raz and his team conducted a survey of specialists throughout Canada, receiving responses from 606 doctors, 257 of them psychiatrists. About 20% of both psychiatrists and non-psychiatrists said they had used placebos in treating patients. The specific treatments they confirmed using included actual placebo tablets, sugar pills and saline injections. Some — including 35% of psychiatrists — said they also used “sub-therapeutic” doses of real drugs, amounts too small to have any chemical effect on the patient.

Interesting. I’ve been a pharmacist for almost 20 years (gulp) and have never seen a prescription for a “placebo” – nor have I ever seen a bottle of  “placebo” tablets waiting for such a prescription. An informal poll with a few colleagues revealed the same thing: No-one has ever seen a “placebo” dispensed. Perhaps my sample isn’t representative. Or it could be these prescriptions are being dispensed by the physician directly from the office.

So my question is to the pharmacists out there: Have you ever seen a prescription for a placebo? Did you fill it? And what did you fill it with? What are your thoughts about filling prescriptions for placebos? Would you do it? And what would you tell your patient?

Don’t ask your pharmacist about Nervoheel N or Neurexan

Magic beans

I can across a strange full-page ad in yesterday’s Globe and Mail. The headline was huge:

Reclaim your inner peace. Homeopathic Preparations. Scientifically proven effective.

Proven effective? Large comprehensive reviews have concluded that homeopathy is not efficacious (that is, it does not work beyond the placebo effect) and that explanations for why homeopathy would work are scientifically implausible. Consequently, it seems quite a stretch to say any homeopathic remedy is “Scientifically proven effective”.  This particular ad was for two homeopathic products from Heel.  Both Nervoheel N (“calms stressful moments, eases nervousness”) and Neurexan (“restores your natural sleep patterns, improves sleep quality”) are approved by Health Canada as safe and effective. Kim Hebert over at Skeptic North went looking for the published clinical evidence to support these efficacy claims:

For Nervoheel N there was one open-label, non-randomized cohort study that stated “The differences between the treatment groups [Nervoheel and lorazepam] were not significant.” The paper concluded that Nervoheel N is non-inferior to lorazepam. No placebo group was included.

For Neurexan there were two studies. Both non-random studies compared Neurexan with another unproven treatment, valerian, in the absence of a placebo group. There is no objective way to separate these results from unintentional researcher/patient bias or the placebo effect. Therefore, the results of both are clinically meaningless.

This data was presumably adequate for Health Canada (search their database for products 80007796 and 80004914 here) unless there’s unpublished data that was supplied.  The ad continues:

Both products are suitable for the whole family, for short or long-term use, as they are clinically proven effective, non-addictive, and non-sedative. They have no known side effects, medicinal interactions, or contraindications.

In order to have side effects, first a product has to have effects. So no surprise there.  The strangest statement, however, is at the bottom of the ad:

AVAILABLE IN PHARMACIES AND HEALTH FOOD STORES.

Ask your chiropractor or naturopath for more infomation.

Presumably they don’t want you to ask your pharmacist for more information. What kind of response might a pharmacist give about the scientific evidence supporting this, or any other homeopathic remedy? Hopefully, a science-based one.